Guideline Wizards

Look up evidence-based follow-up recommendations for incidental findings directly within RadPal.

Overview

The guideline wizard is a built-in tool that helps you generate standardized follow-up recommendations for incidental findings. It walks you through a series of questions — finding type, size, patient risk factors — and produces a guideline-based recommendation that you can insert directly into your report.

Guidelines are implemented as interactive decision trees. Each tree follows the logic of a published guideline (e.g., Fleischner 2017, ACR 2017) and arrives at a specific recommendation based on your answers. The catalog also includes a set of calculators — quick computed measurements like adrenal washout or PSA density — that share the same wizard interface.

Available Guidelines

The catalog contains roughly 30 modules, organized by anatomy into eight categories. Calculators are marked with a CALC badge; risk stratification reporting systems (like TI-RADS) carry a RADS badge.

Neuro & Head — NASCET carotid stenosis (calc); ICH volume, ABC/2 (calc)
Neck — Thyroid nodule US, ACR TI-RADS (point-based RADS calculator); Incidental thyroid nodule on CT/MR/PET, ACR 2015
Chest — Pulmonary nodules, Fleischner Society 2017; Thymus chemical shift, Inaoka 2007 (calc)
Cardiovascular — RV/LV ratio for pulmonary embolism (calc)
Abdomen & Pelvis — Adrenal mass, liver lesion (CT), pancreatic cyst, and renal mass (CT), all ACR 2017; splenic lesion, lymph nodes, gallbladder findings, and biliary dilation, all ACR 2013; Bosniak cystic renal mass, version 2019; plus calculators for adrenal washout (Caoili 2002), prostate bullet volume (Terris–Stamey), PSA density, and hepatic steatosis (in/opposed phase)
Gynecologic — Adnexal cyst on US, SRU 2010; adnexal cyst on CT/MR, ACR 2019
Vascular — Ten modules based on the ACR 2013 incidental vascular findings white paper: abdominal aortic aneurysm, iliac artery aneurysm, splenic artery aneurysm, renal artery aneurysm, other visceral artery aneurysms, penetrating aortic ulcer, isolated SMA dissection, incidental venous thrombosis, venous compression syndromes, and gonadal/pelvic veins
Tools & Calculators — Anatomy-agnostic utilities such as ellipsoid volume (L×W×H×π/6)

Calculators

Alongside published follow-up guidelines, the catalog includes calculators — tools that compute a value from your measurements rather than walking a guideline decision tree. Examples include adrenal washout percentages, NASCET carotid stenosis, ICH volume by ABC/2, RV/LV ratio, PSA density, and ellipsoid volume.

Calculators use the same wizard interface: enter your measurements, get a formatted result you can insert into your report. Anatomy-specific calculators live in their organ category (e.g., adrenal washout under Abdomen & Pelvis), while general-purpose ones live under Tools & Calculators. All of them are marked with a CALC badge in the picker.

Modality-Specific Guidelines

Some finding types have different guidelines depending on the imaging modality. For adnexal findings, RadPal uses:

Ultrasound — SRU 2010 guidelines
CT or MR — ACR 2019 guidelines

When an adnexal finding is detected, a modality dropdown appears in the findings list so you can switch between the appropriate guideline if needed.

Important Notes

The guideline wizard is a reference tool — it surfaces published recommendations to assist your clinical decision-making, but it does not replace clinical judgment. Always verify that the selected guideline and recommendation are appropriate for your specific patient and clinical context.

Guidelines referenced in RadPal are based on published versions at the time of implementation. Check the citation for each recommendation to confirm the source and publication year.